How Ketones Can Combat Alzheimer’s

Previous studies have shown the brain loses its ability to use glucose to produce energy in Alzheimer’s disease. Researchers are now conducting studies to determine if ketones could replace glucose as an energy source for the brain and ultimately restore cognitive ability.

Learn more about ketones and their role in brain health and combating Alzheimer’s.

Replacing Glucose with Ketones to Combat Alzheimer’s

The Alzheimer’s Association International Conference (AAIC) 2017 featured a session focused on the impact of brain ketone metabolism and ketogenic interventions in Alzheimer’s. Ketones are molecules produced by the liver from fatty acids, usually during periods of low food intake or carbohydrate restrictive diets and an energy source for the body.

Stephen Cunnane, Ph.D., from the University of Sherbrooke in Quebec, explains, “We know that in Alzheimer’s disease, the brain loses its ability to use glucose to produce energy. Some areas of the brain are down by 40% in terms of glucose metabolism. We believe that this energy gap increases the risk of neuronal dysfunction and cognitive decline.”

Dr. Cunnane also notes that glucose uptake into the brain frontal cortex has shown to be 14% lower in healthy seniors than in healthy young adults. Additionally, people with early Alzheimer’s have 20-30% less glucose uptake than cognitively healthy seniors. “Anybody trying to function with 20% less brain glucose long term will suffer from brain exhaustion,” he said.

Early studies show that the brain is able to use ketones instead of glucose and is prompting researchers to delve further into the relationship between ketones and the brain to see if ketones can delay cognitive decline in seniors.

Studies Show Increasing Ketones Impacts Brain Health

Two preliminary studies have shown that increasing the uptake of ketones in the brain can have a positive impact on cognitive health.

There are two major ways of increasing ketones in the blood, thus increasing the uptake of ketones to the brain:

Ketogenic Diet

The first way of increasing ketone concentration in the blood is through a ketogenic diet. A ketogenic diet requires extremely low carbohydrate intake, nearly bringing the body to starvation conditions. Dr. Russell H. Swerdlow from the University of Kansas Alzheimer’s Disease Center explains:

“The ketogenic diet has been used in epilepsy for almost 100 years and has been shown to reduce intractable seizures. Our results suggest it could also be useful in other forms of neurological disease like Alzheimer’s, but it is not an easy diet to follow,” he added. “The point of our study is that it helps to establish a principle that brain metabolism can be rescued by a fuel other than glucose.”

His small study involved 15 people diagnosed with mild Alzheimer’s disease. They were placed on a ketogenic diet and given a triglyceride supplement for 3 months. Daily urine tests and monthly measurements of plasma betahydroxybutyrate levels showed the degree of ketosis for each participant. Cognitive function was assessed at the beginning, at the end of the three-month study, and then a month after the study when participants were eating normally again.

Of the 15 participants, 10 stuck to the diet and all 10 showed a significant improvement on the Alzheimer’s Disease Assessment Scale-Cog. All scores returned to normal when the participants returned to their normal diets. Dr. Swerdlow says, “This is just a pilot study – I wouldn’t go so far as to say it worked. But we can say we saw a potential therapeutic signal that warrants further studies to confirm whether there is a real effect. That is definitely exciting.”

Because the diet has such a low carbohydrate intake, it is not recommended for routine use, treatment or prevention of Alzheimer’s. “This is not a diet that people will enjoy being on,” Dr Swerdlow said. “The ultimate goal is not to recommend a ketogenic diet in their daily lives – it will be too difficult. We are just trying to show proof of principle that manipulating brain energy metabolism can impact the symptoms of Alzheimer’s. If we can establish that then we can try and develop other ways to simulate the effects of a ketogenic diet that would hopefully be more palatable.

Triglyceride Supplement

Because of the difficulty in keeping with a ketogenic diet, triglyceride supplements may be an easier way to increase ketone concentration in the blood without sending the body into starvation mode.

While this study is still ongoing, early results are promising. The 50 participants in the study take a triglyceride supplement twice a day and will for a six month period. There are 12 participants who have completed the supplements and preliminary results showed a direct correlation between ketone levels and cognitive function.

Results are still being analyzed and released, but Dr. Cunnane is encouraged by the results thus far. “We are evaluating whether the brain can use the ketones in the supplement, and the answer is definitely yes. That was a critical step. We also saw some signs of cognitive benefits, but it is too small a study to say anything definitive.”

Final results will be available next spring.

What do you think about the relationship between brain health and ketones? Would you put your loved one on a ketogenic diet to improve cognitive health? We’d like to hear your thoughts in the comments below.

Please leave your thoughts and comments

Ed Blonz

I fully support the excellent work by Dr. Cunnane and his colleagues. I encourage all to read the recent paper in the Journal of Alzheimer’s Disease that “connects the dots,” providing a metabolic explanation supporting the biochemical rationale for this approach. (https://www.ncbi.nlm.nih.gov/pubmed/28946565).

Check out the interview about this paper just posted at the University of California, Berkeley Welllness Letter, this article explaining some of the concepts in less-scientific terminology (https://goo.gl/axZqCt).

Valerie Hughes

First of all, I am 61 years old and I am on a strict Therapeutic Ketogenic diet and it is not difficult to follow. The Dr’s Old Medical training/bias is showing. There is no need to use the word “starvation” in connection with a balanced Therapeutic Ketogenic Diet. Recent studies and clinical applications world wide have given birth to wonderful and tasty cookbooks that make a Strict Therapeutic diet varied and delicious. I believe that most people with MCI, SCI, and Dementia should be prescribed a Therapeutic ketogenic diet and followed clinically for a year to document all of the benefits of fat adaptation. And those at risk of ALZ should but themselves on a Ketogenic diet and enjoy along and healthy life.

robininseoul

I was just going to make a similar comment. Come on, keto is not that hard! Those doctors must really be sugar addicted to say that. What baloney.

Gavin Allinson

yes Valerie eating a keto diet is amazing in terms of how full you can feel

Nixnuts

Interesting, I know ketogenic diet may vary in some ways. Maybe it is not necessary to be in very deep ketonic conditios and then you can do it on your own. But the ketogenic diet described in the articel is extremly strict and for ex 20g carbon at all and just very low amount of amino acids can be very challenging. But you are right the science should go on and maybe it is not neccessary to stay at 3,5 keton all the time and 1.0 keton is good…

Gavin Allinson

Great work on this article. Fasting also has a big role to play. Obviously when you fast you produce your own ketones. Also MCT’s can turn into ketones too.

About The Author

Alissa Sauer has been dedicated to writing articles about Alzheimer's research and senior living for over four years. With a Communications Degree from the University of Illinois, Alissa strives to help families understand and manage the changes that often accompany caring for a senior loved one. On a personal note, Alissa enjoys traveling around the world as a military spouse and spending time with her two young children and Golden Retriever.

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